As alloplastic materials used in nasal tip plasty, medical silicone (dimethylsiloxane polymer) which is widely known to those skilled in the art, is mainly used. Further, Gore-Tex, polyethylene terephthalate, Proplast I and II (Medpore™), etc. are used as the alloplastic materials. Meanwhile, as natural materials, autologous cartilage is used in augmentation rhinoplasty.
Such alloplastic materials are of limited use when highly elevating a nasal tip.
It is because the elevation of a nasal tip using alloplastic materials (mainly silicone implants) interferes with the blood supply to the tip of the nose, thus causing the nasal tip to become red. Further, it has been reported that the alloplastic materials frequently penetrate the nasal tip.
For these reasons, when a nasal tip must be very highly elevated, autologous cartilage is commonly used.
Since autologous cartilage can make a much more beautiful nasal tip in the augmentation rhinoplasty, in comparison with silicone, plastic surgeons prefer autologous cartilage to silicone in the nasal tip plasty.
In the case of using autologous cartilage, ear cartilage or septal cartilage is mainly used, as shown in FIGS. 15 and 17. However, an operation using the autologous cartilage has a drawback in that more effort and time are required, compared to an operation using a silicone implant.
Nasal tip plasty using autologous cartilage is performed as follows.
Generally, a silicone implant or Gore-Tex is used for the dorsum (or, ridge) of the nose. Nasal tip plasty using autologous cartilage is performed on a nasal tip.
When the nose being subjected to augmentation rhinoplasty is cut open, as shown in FIG. 16, the nasal ridge (nasal vault) is divided into a cartilaginous vault and a bony vault.
As shown in FIGS. 16 and 17, the cartilaginous vault includes upper lateral cartilage and septal cartilage.
When viewing the upper lateral cartilage from the front, the upper lateral cartilage has a triangular shape and is firmly coupled to a nasal bone. This becomes the foundation of the nose, and includes the upper lateral cartilage, the nasal bone, the septal cartilage, and a perpendicular plate of the ethmoid bone.
Meanwhile, as shown in FIGS. 18 and 19, the lower lateral cartilage is divided into medial crura, middle crura, and lateral crura. A tip defining point (TDP) is defined by the vaults of the middle crura, a supratip breakpoint, and an infratip breakpoint. When viewing the lower lateral cartilage from the front, the lower lateral cartilage is seen to have a diamond shape (see FIG. 20).
The nasal tip includes the lower lateral cartilage. The shape of the nasal tip is mainly determined by the shape and structure of the lower lateral cartilage (see FIG. 19).
The work of harvesting the cartilage is conducted by harvesting some ear cartilage or septal cartilage, as shown in FIGS. 15 and 17.
When nasal tip plasty is performed after the cartilage is harvested, the cartilage is divided into several pieces, according to the intended purpose.
First, as shown in FIGS. 21 to 23, a strut is made of the cartilage and then is set up on the columellar.
When the medial crura of the lower lateral cartilage are secured to the strut, tension sufficient to elevate the nasal tip is created. In this state, cap grafting (see FIG. 23) or shield grafting (see FIG. 22) is performed, thus forming the nose into an intended shape.
When the strut is set up the strut is frequently connected to an upper border of the septal cartilage or the anterior nasal spine (see FIG. 21). The upper border is a region of a nose defined from the dorsum to the anterior nasal spine. Especially when the strut is held on the upper border of the septal cartilage, the parts must be stitched to each other one by one in a narrow space, which takes a long time.
Further, this method is problematic in that the cartilage is apt to warp or be deformed, so that it is difficult to make an intended shape. To solve this problem, there is used the paired batten graft for doubly placing cartilage to the septal cartilage in a columellar direction or the paired spreader graft for doubly placing cartilage to the septal cartilage in a cephalo-caudal direction. However, this method consumes more cartilage and increases time taken for operation.
The above information disclosed in this Background section is only for enhancement of understanding of the background of the invention and therefore it may contain information that does not form the prior art that is already known in this country to a person of ordinary skill in the art.